Schizophrenia, ( Undifferentiated Type )

By Dr. Cheryl Lane, PhD

A diagnosis of undifferentiated schizophrenia is given when a patient has been exhibiting symptoms of schizophrenia, yet the symptoms don’t meet the criteria for disorganized, catatonic, or paranoid schizophrenia.

Essentially, undifferentiated schizophrenia is the “NOS” (not otherwise specified”) version of schizophrenia. (An “NOS” version is used in almost all other types of mental health disorders, such as “depressive disorder, NOS” or “personality disorder, NOS”). It’s clearly schizophrenia, but it doesn’t neatly fit any of the other types – hence the name “undifferentiated”.

Symptoms of undifferentiated schizophrenia

According to the DSM, individuals with undifferentiated schizophrenia must exhibit symptoms for a month or more that meet “criterion A” for schizophrenia. Criterion A is comprised of the following.

Two or more of the following symptoms are present:

• Hallucinations (e.g. hearing or seeing things that aren’t actually there)
• Delusions (false, firmly held beliefs (despite evidence to the contrary) that aren’t typically held by others – e.g. believing that one has superhuman powers or is constantly being watched via hidden cameras everywhere)
• Disorganized speech (e.g. gibberish or constantly jumping from one topic to another)
• Catatonic or extremely disorganized behavior (e.g. being in a stupor, staying in a rigid position for a long period of time, echolalia, or wearing several layers of clothes on a hot summer day)
• Negative symptoms (e.g. little or no display of emotion, inability to do simple, day-to-day tasks, very brief and empty responses to questions)

There are two exceptions to the above:

1. The presence of only one of the above symptoms is sufficient if it consists of bizarre delusions (meaning something that is completely beyond the realm of possibility), hearing voices that are conversing with each other, or hearing a voice (or voices) that is constantly commenting on the person’s thoughts or actions.
2. If the symptoms subside due to successful treatment, the timeframe can be less than one month.

With paranoid schizophrenia, auditory hallucinations and / or delusions are prominent. With disorganized schizophrenia, the salient symptoms are disorganized speech, inappropriate or blunted emotional expression, and severely disorganized behavior. And with catatonic schizophrenia, significant psychomotor disturbances are prominent. However, with undifferentiated schizophrenia, no particular symptom or set of symptoms listed above dominates the clinical picture.

Associated Characteristics

As with all types of schizophrenia, the onset of symptoms prevents individuals with undifferentiated schizophrenia from functioning normally in one or more major areas of life. These areas include school, work, normal day-to-day tasks, relationships, and social interactions.

Treatment for undifferentiated schizophrenia

Medication

As with all types of schizophrenia, undifferentiated schizophrenia usually requires ongoing treatment with antipsychotic medication. Antipsychotic medications, such as Zyprexa or Risperdal, can help keep symptoms under control. They also help prevent the recurrence of future episodes. Other medications may also be beneficial if, for example, the patient is experiencing mood symptoms or symptoms of anxiety.

Additional types of treatment, once the patient is stable, may include:

• Individual therapy, such as cognitive behavioral therapy
• Group therapy
• Family therapy
• Self-help groups
• Dual diagnosis treatment (if the patient is abusing or addicted to alcohol or drugs)
• Social skills training
• Vocational rehabilitation

Other Related Aspects

If prominent mood symptoms, such as depression or mania, are present, a diagnosis of schizoaffective disorder or another mood disorder may be more appropriate - depending on the timeframe of the mood symptoms as well as other related factors.

Related Reading

Types of schizophrenia

• Paranoid Schizophrenia
• Disorganized (hebephrenic) schizophrenia
• Catatonic Schizophrenia
• Residual schizophrenia